Individual
AMY LYNN SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
(503) 370-4313
Mailing address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
(503) 370-4313
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7399
OR
126800000X
Dental Assistant
118980
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118980
OREGON BOARD OF DENTISTRY
OR
01
—
H7399
OREGON BOARD OF DENTISTRY
OR
Enumeration date
05/07/2012
Last updated
05/04/2017
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